The European Guidelines for Medical Oncology (ESMO) have published a new guide to mesothelioma diagnosis and treatment, an addition that the journal hopes will increase early diagnoses and improve treatment efficacy. The protocol is particularly important due to the terminal disease’s relative infrequency, its general symptoms, and the profound impact that early diagnosis can have on survival times.
Mesothelioma, an aggressive and terminal cancer of a specific tissue which encases the body’s vital organs, is caused almost exclusively by asbestos exposure. The disease can take from twenty to fifty years to develop from initial exposure to asbestos, and presents with symptoms shared by a variety of general ailments. The long latency period and vague symptoms make it particularly difficult to diagnose, and its aggressive progression makes it an incredibly dangerous disease with a normally grim prognosis. The publication in the European Guidelines for Medical Oncology provide some standard diagnostic and treatment procedures which hope to help doctors diagnose mesothelioma more quickly and treat it more efficiently.
The guidelines state that one of the first symptoms of the disease is often shortness of breath and varying degrees of chest pain. An X-ray can help to discern whether the chest wall has begun to thicken – another symptom of the disease – and a test performed on the fluid accumulating in the chest cavity along with an audit of the patient’s occupational history can help to narrow the possibilities. If all tests at this point indicate a possibility of mesothelioma, the new guidelines suggest a biopsy to confirm the diagnosis.
In addition to symptomatic diagnosis, the guidelines discuss the possibility of further inferring a positive diagnosis by recognizing two specific protein markers found in the patient’s blood serum. While the role these proteins play is still relatively uncertain their presence has been correlated with a positive mesothelioma diagnosis.
A wide variety of experimental treatments exist for mesothelioma, but the ESMO report continues to support the traditional treatment methods of surgery, chemotherapy, and radiotherapy. Surgery, claims the new guidelines, should only be performed in early stages of the disease and should be followed by chemotherapy and combination radiotherapy where necessary. A variety of combination, or multi-modal, therapies – that is, collections of specific drugs and administration techniques – exist which have shown particular efficacy in different circumstances.
While mesothelioma is still considered a rare disease, its long latency period suggests that diagnoses will continue to rise considerably. Guidelines such as the new ESMO publication could help doctors to deal with rising instances of the disease.
